Average Medicaid Office Visit Payments in Sumter, SC: $76.88
Avg. Paid
$76.88
Range
$0.00 – $345.00
Total Claims
592,225
Providers
199
Typical Payment Range
Typical Medicaid Office Visit payments fall between $29.28 and $67.92 per claim (median: $46.55). The top 10% of payments exceed $95.29.
Based on per-provider averages across all Medicaid claims in this category.
A standard doctor's office visit for evaluation and management of medical conditions. Includes new patient visits, follow-up visits, and consultations.
Understanding these costs
The amounts shown are Medicaid reimbursement rates — what state Medicaid programs paid providers per claim. Medicaid typically pays well below private insurance rates and out-of-pocket prices. Use this data to compare relative costs between providers, not as a price estimate for privately insured or self-pay patients.
Providers Offering Office Visit in Sumter, SC
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
South Carolina Dept Of Mental Health Accounting Office
801 N Pike W |
$132.65 | 42,648 | 38,317 |
|
Alisha Janette Davis
129 N Washington St |
$5.22 | 40,857 | 22,934 |
|
James M Durant
237 Church St |
$79.09 | 32,054 | 26,929 |
|
Jason Brooks Grier
237 Church St |
$81.73 | 29,441 | 26,489 |
|
Timothy L Key
237 Church St |
$77.99 | 26,569 | 23,231 |
|
John Mark Mitchiner
237 Church St |
$78.66 | 23,892 | 21,194 |
|
Melissa W Arscott
237 Church St |
$77.99 | 22,556 | 19,951 |
|
Michele Renee Easler
237 Church St |
$76.47 | 19,943 | 15,662 |
|
David C Turell
370 S. Pike West |
$215.82 | 12,838 | 11,867 |
|
Kurtis Rodine
319 N. Main St. |
$60.78 | 9,583 | 9,062 |
|
Arvie Cecil Collins
115 N Sumter St |
$65.46 | 8,249 | 7,411 |
|
Elizabeth Brockinton
742 W Liberty St |
$87.52 | 8,206 | 7,564 |
|
Mark A Hucks
115 N Sumter St |
$62.90 | 8,022 | 7,089 |
|
State Of South Carolina
407 N Salem Ave |
$50.65 | 7,756 | 7,592 |
|
Hanna S Rivers
325 Broad St |
$56.59 | 7,321 | 6,865 |
|
Triz Van Smith
115 N Sumter St |
$64.77 | 7,263 | 6,450 |
|
Jill Braddy Mcleod
115 N Sumter St Ste 200 |
$64.75 | 6,990 | 6,259 |
|
Mary Kathleen Cox
325 Broad St Ste 200 |
$21.41 | 6,922 | 6,137 |
|
Usah Lilavivat
635 W Wesmark Blvd |
$56.73 | 6,860 | 5,999 |
|
Edward Julian Meyers
325 Broad St Ste 100 |
$59.99 | 6,784 | 6,167 |
|
Kristin Marie Bell
115 N Sumter St Ste 110 |
$72.90 | 6,565 | 5,401 |
|
Shao-Zheng Ding
115 N Sumter St Ste 400 |
$2.13 | 6,498 | 5,176 |
|
Nelson H Sturgis
370 S Pike W |
$182.48 | 6,494 | 6,059 |
|
Christopher Mahr
698 Bultman Dr |
$42.37 | 6,401 | 5,094 |
|
William Scott Kellogg
1105 N Lafayette Dr |
$30.11 | 6,362 | 5,470 |
|
Thomas Lawman Lucas
325 Broad St |
$45.63 | 6,266 | 5,453 |
|
Joseph P Grant
325 Broad St |
$60.08 | 6,089 | 5,771 |
|
Steven Jon Bosc
325 Broad St |
$54.49 | 5,978 | 5,539 |
|
Joel Janeen-Belton Snipe
319 N Main St |
$198.78 | 5,492 | 4,784 |
|
Vijay Paul Pinto
1285 Wilson Hall Road |
$26.90 | 5,487 | 5,164 |
|
Kimberly Daves Ashley
370 South Pike West |
$124.76 | 5,324 | 4,940 |
|
Lisa Ann Oshaughnessy Turnure
801 N Pike W |
$25.80 | 5,254 | 2,166 |
|
Tracy Debolt Ridgill
649 W Wesmark Blvd |
$44.83 | 5,216 | 4,687 |
|
Wendy L Marean
10 Miller Rd |
$65.57 | 4,605 | 4,277 |
|
John Evans James
237 Church St |
$83.81 | 4,596 | 4,232 |
|
Prisma Health-Midlands
129 N. Washington Street |
$22.57 | 4,568 | 4,112 |
|
Russell V Brant
1278 N Lafayette Dr |
$195.98 | 4,395 | 4,233 |
|
David Glenn Whaley
325 Broad St |
$46.62 | 4,337 | 3,541 |
|
Carrie Elliott Hoshour
325 Broad St |
$47.63 | 4,322 | 4,131 |
|
Matthew J Furman
215 W Hampton Ave |
$32.41 | 4,178 | 3,880 |
|
Barbara Jean Epps
325 Broad St Ste 100 |
$46.03 | 4,136 | 3,707 |
|
Stephen Gregory Buck
1283 Broad St |
$50.83 | 4,131 | 3,871 |
|
Lisa Jeffus Smith
1761 Pinewood Road |
$50.68 | 4,105 | 3,924 |
|
Manuel F Gonzalez
115 N Sumter St |
$36.94 | 4,074 | 2,975 |
|
Elizabeth Marie Disher
100 N Sumter St Ste 202 |
$60.03 | 3,992 | 3,839 |
|
Ike Christopher Stewart
308 W Wesmark Blvd |
$41.23 | 3,768 | 3,150 |
|
Linda S Crabbe
370 S Pike W |
$190.89 | 3,759 | 3,734 |
|
Efua Akyea Wilmot
370 S Pike W |
$237.85 | 3,670 | 3,424 |
|
Grace Wielicki Couch
325 Broad St |
$51.15 | 3,570 | 3,364 |
|
David A Justice
1278 N Lafayette Dr |
$161.25 | 3,545 | 3,450 |
What to Expect: Office Visit
A typical office visit lasts 15-45 minutes depending on complexity. Your doctor will review your medical history, discuss symptoms, perform a physical exam, and discuss treatment options. You may receive prescriptions, referrals, or orders for diagnostic tests. Follow-up visits are usually shorter than new patient visits.
Cost Components
National average Medicaid payment per billing code. Individual rates vary by provider and state.
| Code | Description | Avg. Paid | Claims | Providers |
|---|---|---|---|---|
| 99213 | Office visit established mod | $43.18 | 764,306,590 | 487,602 |
| 99214 | Office visit established mod-hi | $59.53 | 502,480,931 | 466,856 |
| 99212 | Office visit established low | $41.69 | 92,299,154 | 127,462 |
| 99203 | Office visit new moderate | $67.55 | 47,756,882 | 127,334 |
| 99211 | Office visit established minor | $39.24 | 44,127,221 | 47,748 |
| 99204 | Office visit new moderate-high | $92.03 | 32,379,031 | 111,937 |
| 99215 | Office visit established high | $93.58 | 29,619,773 | 74,725 |
| 99202 | Office visit new low | $58.57 | 9,372,712 | 35,486 |
| 99205 | Office visit new high | $136.10 | 3,665,382 | 19,737 |
| 99244 | Office consultation mod-high | $118.25 | 3,405,681 | 11,884 |
| 99243 | Office consultation moderate | $78.55 | 2,585,480 | 8,432 |
| 99245 | Office consultation high | $132.29 | 645,300 | 3,046 |
| 99242 | Office consultation low | $58.27 | 483,445 | 1,980 |
| 99241 | Office consultation brief | $66.15 | 295,664 | 712 |
These are national Medicaid averages for each billing code. Actual amounts vary by state, provider, and complexity.
Frequently Asked Questions
How much does a Office Visit cost in Sumter, SC?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Sumter, SC is $76.88 per claim, based on 592,225 claims from 199 providers. Typical payments fall between $29.28 and $67.92. Note: Medicaid rates are typically much lower than private insurance or self-pay prices.
How many providers offer Office Visit in Sumter, SC?
There are 199 Medicaid providers offering Office Visit related services in Sumter, SC according to public payment data.
What is the price range for Office Visit in Sumter, SC?
Medicaid reimbursement for Office Visit in Sumter, SC ranges from $0.00 to $345.00 per claim, with an average of $76.88. Private insurance and self-pay costs are typically higher than these Medicaid rates.
Office Visit in Other Cities
Brooklyn, NY
Avg $71.20
32,336,840 claims · 5588 providers
New York, NY
Avg $81.86
23,551,154 claims · 7530 providers
Los Angeles, CA
Avg $24.20
16,948,065 claims · 5565 providers
Chicago, IL
Avg $30.31
13,989,780 claims · 5801 providers
Bronx, NY
Avg $82.40
13,626,712 claims · 3705 providers
Phoenix, AZ
Avg $47.53
13,269,420 claims · 4233 providers
Houston, TX
Avg $48.27
8,766,644 claims · 4540 providers
Las Vegas, NV
Avg $54.47
8,578,324 claims · 3512 providers
Other Procedures in Sumter, SC
Blood Work & Lab Tests
Avg $12.51
300,851 claims
Dental Cleaning & Exam
Avg $34.02
167,492 claims
Vaccines & Immunizations
Avg $19.55
162,920 claims
Emergency Room Visit
Avg $38.43
157,791 claims
Urinalysis & Urine Tests
Avg $21.60
129,948 claims
Speech Therapy
Avg $38.90
125,766 claims
Home Health Visit
Avg $44.33
116,753 claims
Psychiatric Evaluation
Avg $158.47
109,398 claims